How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | None | $147.91 | $151.36 | $186.21 |
BCBS Montana Setting Facility Modifier None Typical Low $186.21 Median $501.19 Typical High $912.01 | Facility | None | $186.21 | $501.19 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $134.90 Median $169.82 Typical High $199.53 | Facility | None | $134.90 | $169.82 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $199.53 | Professional | None | $134.90 | $177.83 | $199.53 |
Providence Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $186.21 | Professional | None | $79.43 | $162.18 | $186.21 |
United Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $87.10 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $37.15 | Professional | 53 · Discontinued | $29.51 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $18.62 |
Where Montana sits
The same service costs 2.4 times more in Wyoming than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Montana· 5th of 51
$162
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.